不同压力负压闭式引流术对足踝部碾轧伤疗效分析

目的探讨高、中、低三种负压闭式引流（vacuum sealing drainage，VSD）术对足踝部碾轧伤治疗效果，并为足踝部碾轧伤治疗提供合适的VSD负压值。方法2008年10月-2010年3月，应用VSD高（-40．1—-60kPa）、中（-20．1--40kPa）、低（-16．6--20kPa）三种压力对足踝部碾轧伤进行治疗，观察不同负压梯度下患者的体温、引流量、局部微循环等变化。术后1个月和6个月分别进行Maryland足功能评分．并对评分结果进行统计学分析。结果本组27例术后随访6～12个月，完整随访24例，随访率78％：VSD三种压力治疗组在术后1个月差异无显著性（P〉0．01），但术后6个月统计学分析差异有显著性（P〈0．01）。结论VSD技术是治疗足踝部碾轧伤的一种可靠、实用的方法，高（-40．1—-60kPa）负压力治疗组较其他两组可获得更好的足功能恢复。

The analysis of clinical efficacy on rolled foot and ankle injury by different pressure techniques of vacuum sealing drainage

Objective To study the clinical efficacy by high,medium and low vacuum sealing drainage （VSD） negative pressure in the treatment of rolled foot and ankle injuries and to provide right VSD negative value. Methods From October 2008 to March 2010, the patients of rolled foot and ankle injuries were treated by high（-40.1-60kPa）, medium（-20.l--40kPa） and low （-16.6--20kPa） negative pressure group of VSD, and to record the patients body temperature, drainage and local microcirculation of different negative pressure, they were respectively Marland foot function score on 1 month and 6 month after surgery, and the result were statistically analyzed. Results There were 27 patients with VSD. The follow-up period ranged from 6 months to 1 year, 24 cases were completed followed up in 27 cases, the follow-up rate were 78%. High, medium and low negative pressure of VSD groups were no significant difference（P〉0.01） in 1 month after surgery, but there were statistically significant difference（P〈 0.01） in 6 month after surgery. Conclusion The technique of VSD in the treatment of rolled foot and ankle injuries is a reliable, practical methods; High （-40. 1--60kpa） negative pressure group can get better functional recovery than the other groups.